HomeMy WebLinkAboutDrain Layers Permit 60 Bramblebrae �Gs 'K7 TOWN OF SOUTH WI N DSOR
DEPARTMENT OF PUBLIC WORKS
BUREAU OF POLLUTION CONTROL
DRAIN LAYER'S PERMIT NNt), 4972
19
Pursuant to written application, permission is he eby granted Pq the Licensed Drain Layer
named herein to perform the work in icated below at , ,F? �,�,f,,�'D (�0
at premises owned by n S d ��C c�j whose address is
and to
Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use, with
Family Units, with acres.
Type of Sewage to be connected under this permit: SANITARY SEWAGE ( ), INDUSTRIAL
WASTES ( ), OR ( ) Connection will be made with
Show sketch of proposed work or furnish two (2) copies of separate drawings.
SPECIAL CONDITIONS
Desired Starting Date - 97 Estimated Time for Completion
Permit to be issued to ,A; SL1170e— (f611J = �i- 1/,dC,
the holder of Drain Layer's License No. d 7�1 Permit will expire thirty (30) days
after date of issuance. The undersigned Drain Layer hereby agrees to all the terms and
conditions set forth in the permit and the reverse i thereof. Applicant has r ceived
Town Permit No. and/or CHD Permit No.
Signed
Licensed rain Layer
The above named Drain Layer has a valid licen a issued by the State of Connecticut and
has filed a satisfactory bond and insurance policy in the name of the To of South Windsor:
Engin ering Dep ent Date
Connection Paid Charge [�C�L� //
g < dr Permit Fee: Paid
Check Numb- r
-1 AJ Ab,
Issued by
Tax Office
INSPECTION
Date work started Date completed
Sufficient notification received: Yes No
Special Conditions
APPROVED:
Inspector Date